Provider Demographics
NPI:1700503570
Name:WEIJEI LIAO DPM PC
Entity Type:Organization
Organization Name:WEIJEI LIAO DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WEIJEI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-515-4614
Mailing Address - Street 1:363 HARNED RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5117
Mailing Address - Country:US
Mailing Address - Phone:917-515-4614
Mailing Address - Fax:718-224-5209
Practice Address - Street 1:230 HILTON AVE STE 208
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8116
Practice Address - Country:US
Practice Address - Phone:917-515-4614
Practice Address - Fax:718-224-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty